Provider Demographics
NPI:1285222935
Name:TOLAN, TONYA (RN)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:TOLAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 WILD EAGLE RUN
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32766-8131
Mailing Address - Country:US
Mailing Address - Phone:407-319-4025
Mailing Address - Fax:
Practice Address - Street 1:3512 WILD EAGLE RUN
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32766-8131
Practice Address - Country:US
Practice Address - Phone:407-319-4025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9239125163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse